Immunotherapy for lung cancer

Immunotherapy drugs are used to treat some non-small cell lung cancers (NSCLC) that have spread outside the lung or to other parts of the body. Rarely, they may be used to treat SCLC.

About immunotherapy for lung cancer

Immunotherapy and targeted therapy drugs are used to treat non-small cell lung cancer (NSCLC) that has spread outside the lung or to other parts of the body.

They are not commonly used for small-cell lung cancer (SCLC). Sometimes a combination of immunotherapy and chemotherapy for SCLC may be given.

Immunotherapy drugs use the immune system to find and attack cancer cells. They include the following:

  • Pembrolizumab (Keytruda®)

    Pembrolizumab may be your first treatment if tests show it is likely to work well for you. You may have it alone or with chemotherapy.

  • Atezolizumab (Tecentriq®)

    Atezolizumab may be given:

    • on its own, after treatment with chemotherapy
    • with a targeted therapy drug called bevacizumab (Avastin®) and chemotherapy 
    • as the first treatment for non-squamous NSCLC
    • aafter you have already had treatment with an EGFR or ALK targeted therapy drug.

    Atezolizumab may be give with chemotherapy for extensive stage small-cell lung cancer.

  • Durvalumab (Imfinzi®)

    Durvalumab may be given for up to a year after chemoradiation to reduce the risk of the cancer coming back.

  • Nivolumab (Opdivo®)

    Nivolumab can be given on its own after you have already had treatment with chemotherapy.

These drugs target and block a protein (receptor) called PD-1 on the surface of T cells, which are part of the immune system. They also block another protein called PD-L1. By blocking PD-1 or PD-L1, these drugs help the immune system to find and attack the cancer cells.

For some drugs you may need tests on the cancer cells to check the levels of PD-L1. The results can tell your doctor how likely a drug is to be helpful.

But these drugs can still work for you even if results don’t show high levels of PD-L1. 

How immunotherapy drugs are given

You have the drugs as a drip (infusion) into a vein. A nurse will give them to you in the chemotherapy day unit.

You can have these immunotherapy drugs for up to 2 years if they are controlling the cancer. But if you develop certain side effects, treatment may need to be stopped.

New immunotherapy drugs are also being developed.

Side effects of immunotherapy for lung cancer

Your doctor or nurse will tell you about the side effects of the immunotherapy drug you are having. They will tell you how side effects can be treated and what you can do to manage them.

Immunotherapy drugs can sometimes make the immune system attack other parts of the body. This is not common, but it can cause serious side effects in:

  • the lungs
  • other organs, such as the liver or bowel
  • glands that make certain hormones.

Sometimes the treatment may need to be stopped. You may need to take steroids for a short while to suppress your immune system.

Rarely, these side effects can happen up to 2 years after the treatment has stopped. These are called late effects. If you think you have any of these side effects, contact your cancer doctor or nurse straight away.

Your doctor or nurse will explain all these side effects to you. Always tell them about any side effects you have.

Getting support

Macmillan is also here to support you. If you would like to talk, you can:

About our information

  • References

    Below is a sample of the sources used in our lung cancer information. If you would like more information about the sources we use, please contact us at  cancerinformationteam@macmillan.org.uk

    National Institute for Health and Care Excellence (NICE). Lung cancer – Diagnosis and management. Clinical guideline 2019.

    Metastatic non-small cell lung cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2018.

    European Society for Medical Oncology (ESMO). Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. 2017.

  • Reviewers

    This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr David Gilligan, Consultant Clinical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We try to make sure our information is as clear as possible. We use plain English, avoid jargon, explain any medical words, use illustrations to explain text, and make sure important points are highlighted clearly.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected. Our aims are for our information to be as clear and relevant as possible for everyone.

You can read more about how we produce our information here.